|
FOLIC ACID 1 MG TABLET
|
Facility
|
IP
|
$188.00
|
|
|
Service Code
|
NDC 65162-361-10
|
| Hospital Charge Code |
3233
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$82.72 |
| Max. Negotiated Rate |
$169.20 |
| Rate for Payer: Aetna American Axle |
$122.20
|
| Rate for Payer: Aetna Commercial |
$159.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$122.20
|
| Rate for Payer: Cash Price |
$150.40
|
| Rate for Payer: Cofinity Commercial |
$131.60
|
| Rate for Payer: Cofinity Commercial |
$161.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$150.40
|
| Rate for Payer: Healthscope Commercial |
$169.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$131.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$141.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$159.80
|
| Rate for Payer: PHP Commercial |
$159.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$131.60
|
| Rate for Payer: Priority Health SBD |
$118.44
|
| Rate for Payer: UMR Bronson Commercial |
$82.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$141.00
|
|
|
FOLIC ACID 1 MG TABLET
|
Facility
|
IP
|
$224.00
|
|
|
Service Code
|
NDC 11534-165-01
|
| Hospital Charge Code |
3233
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$98.56 |
| Max. Negotiated Rate |
$201.60 |
| Rate for Payer: Aetna American Axle |
$145.60
|
| Rate for Payer: Aetna Commercial |
$190.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$145.60
|
| Rate for Payer: Cash Price |
$179.20
|
| Rate for Payer: Cofinity Commercial |
$156.80
|
| Rate for Payer: Cofinity Commercial |
$192.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$179.20
|
| Rate for Payer: Healthscope Commercial |
$201.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$156.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$168.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$190.40
|
| Rate for Payer: PHP Commercial |
$190.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$156.80
|
| Rate for Payer: Priority Health SBD |
$141.12
|
| Rate for Payer: UMR Bronson Commercial |
$98.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$168.00
|
|
|
FOLIC ACID 1 MG TABLET
|
Facility
|
IP
|
$1.50
|
|
|
Service Code
|
NDC 62584-897-11
|
| Hospital Charge Code |
3233
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.66 |
| Max. Negotiated Rate |
$1.35 |
| Rate for Payer: Aetna American Axle |
$0.98
|
| Rate for Payer: Aetna Commercial |
$1.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.98
|
| Rate for Payer: Cash Price |
$1.20
|
| Rate for Payer: Cofinity Commercial |
$1.05
|
| Rate for Payer: Cofinity Commercial |
$1.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.20
|
| Rate for Payer: Healthscope Commercial |
$1.35
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1.28
|
| Rate for Payer: PHP Commercial |
$1.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1.05
|
| Rate for Payer: Priority Health SBD |
$0.95
|
| Rate for Payer: UMR Bronson Commercial |
$0.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.12
|
|
|
FOLIC ACID 1 MG TABLET
|
Facility
|
IP
|
$284.00
|
|
|
Service Code
|
NDC 63739-537-10
|
| Hospital Charge Code |
3233
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$124.96 |
| Max. Negotiated Rate |
$255.60 |
| Rate for Payer: Aetna American Axle |
$184.60
|
| Rate for Payer: Aetna Commercial |
$241.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$184.60
|
| Rate for Payer: Cash Price |
$227.20
|
| Rate for Payer: Cofinity Commercial |
$198.80
|
| Rate for Payer: Cofinity Commercial |
$244.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$227.20
|
| Rate for Payer: Healthscope Commercial |
$255.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$198.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$213.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$241.40
|
| Rate for Payer: PHP Commercial |
$241.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$198.80
|
| Rate for Payer: Priority Health SBD |
$178.92
|
| Rate for Payer: UMR Bronson Commercial |
$124.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$213.00
|
|
|
FOLIC ACID 5 MG/ML INJECTION SOLUTION
|
Facility
|
OP
|
$203.55
|
|
|
Service Code
|
NDC 63323-184-10
|
| Hospital Charge Code |
3232
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$75.31 |
| Max. Negotiated Rate |
$183.20 |
| Rate for Payer: Aetna American Axle |
$132.31
|
| Rate for Payer: Aetna Commercial |
$173.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$132.31
|
| Rate for Payer: BCBS Complete |
$81.42
|
| Rate for Payer: Cash Price |
$162.84
|
| Rate for Payer: Cofinity Commercial |
$142.48
|
| Rate for Payer: Cofinity Commercial |
$175.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$162.84
|
| Rate for Payer: Healthscope Commercial |
$183.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$142.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$152.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$173.02
|
| Rate for Payer: PHP Commercial |
$173.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$142.48
|
| Rate for Payer: Priority Health SBD |
$128.24
|
| Rate for Payer: UMR Bronson Commercial |
$75.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$152.66
|
|
|
FOLIC ACID 5 MG/ML INJECTION SOLUTION
|
Facility
|
OP
|
$5.69
|
|
|
Service Code
|
NDC 63323-184-11
|
| Hospital Charge Code |
3232
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$2.11 |
| Max. Negotiated Rate |
$5.12 |
| Rate for Payer: Aetna American Axle |
$3.70
|
| Rate for Payer: Aetna Commercial |
$4.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3.70
|
| Rate for Payer: BCBS Complete |
$2.28
|
| Rate for Payer: Cash Price |
$4.55
|
| Rate for Payer: Cofinity Commercial |
$3.98
|
| Rate for Payer: Cofinity Commercial |
$4.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.55
|
| Rate for Payer: Healthscope Commercial |
$5.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4.84
|
| Rate for Payer: PHP Commercial |
$4.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.98
|
| Rate for Payer: Priority Health SBD |
$3.58
|
| Rate for Payer: UMR Bronson Commercial |
$2.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4.27
|
|
|
FOLIC ACID 5 MG/ML INJECTION SOLUTION
|
Facility
|
OP
|
$283.19
|
|
|
Service Code
|
NDC 39822-1100-1
|
| Hospital Charge Code |
3232
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$104.78 |
| Max. Negotiated Rate |
$254.87 |
| Rate for Payer: Aetna American Axle |
$184.07
|
| Rate for Payer: Aetna Commercial |
$240.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$184.07
|
| Rate for Payer: BCBS Complete |
$113.28
|
| Rate for Payer: Cash Price |
$226.55
|
| Rate for Payer: Cofinity Commercial |
$198.23
|
| Rate for Payer: Cofinity Commercial |
$243.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$226.55
|
| Rate for Payer: Healthscope Commercial |
$254.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$198.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$212.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$240.71
|
| Rate for Payer: PHP Commercial |
$240.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$198.23
|
| Rate for Payer: Priority Health SBD |
$178.41
|
| Rate for Payer: UMR Bronson Commercial |
$104.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$212.39
|
|
|
FOLIC ACID 5 MG/ML INJECTION SOLUTION
|
Facility
|
IP
|
$284.49
|
|
|
Service Code
|
NDC 63323-184-11
|
| Hospital Charge Code |
3232
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$125.18 |
| Max. Negotiated Rate |
$256.04 |
| Rate for Payer: Aetna American Axle |
$184.92
|
| Rate for Payer: Aetna Commercial |
$241.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$184.92
|
| Rate for Payer: Cash Price |
$227.59
|
| Rate for Payer: Cofinity Commercial |
$244.66
|
| Rate for Payer: Cofinity Commercial |
$199.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$227.59
|
| Rate for Payer: Healthscope Commercial |
$256.04
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$199.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$213.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$241.82
|
| Rate for Payer: PHP Commercial |
$241.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$199.14
|
| Rate for Payer: Priority Health SBD |
$179.23
|
| Rate for Payer: UMR Bronson Commercial |
$125.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$213.37
|
|
|
FOLIC ACID 5 MG/ML INJECTION SOLUTION
|
Facility
|
IP
|
$203.55
|
|
|
Service Code
|
NDC 63323-184-10
|
| Hospital Charge Code |
3232
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$89.56 |
| Max. Negotiated Rate |
$183.20 |
| Rate for Payer: Aetna American Axle |
$132.31
|
| Rate for Payer: Aetna Commercial |
$173.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$132.31
|
| Rate for Payer: Cash Price |
$162.84
|
| Rate for Payer: Cofinity Commercial |
$142.48
|
| Rate for Payer: Cofinity Commercial |
$175.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$162.84
|
| Rate for Payer: Healthscope Commercial |
$183.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$142.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$152.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$173.02
|
| Rate for Payer: PHP Commercial |
$173.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$142.48
|
| Rate for Payer: Priority Health SBD |
$128.24
|
| Rate for Payer: UMR Bronson Commercial |
$89.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$152.66
|
|
|
FOLIC ACID 5 MG/ML INJECTION SOLUTION
|
Facility
|
IP
|
$283.19
|
|
|
Service Code
|
NDC 39822-1100-1
|
| Hospital Charge Code |
3232
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$124.60 |
| Max. Negotiated Rate |
$254.87 |
| Rate for Payer: Aetna American Axle |
$184.07
|
| Rate for Payer: Aetna Commercial |
$240.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$184.07
|
| Rate for Payer: Cash Price |
$226.55
|
| Rate for Payer: Cofinity Commercial |
$198.23
|
| Rate for Payer: Cofinity Commercial |
$243.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$226.55
|
| Rate for Payer: Healthscope Commercial |
$254.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$198.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$212.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$240.71
|
| Rate for Payer: PHP Commercial |
$240.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$198.23
|
| Rate for Payer: Priority Health SBD |
$178.41
|
| Rate for Payer: UMR Bronson Commercial |
$124.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$212.39
|
|
|
FOLIC ACID-VIT B6-VIT B12 2.5 MG-25 MG-2 MG TABLET
|
Facility
|
IP
|
$285.56
|
|
|
Service Code
|
NDC 7583408090
|
| Hospital Charge Code |
38624
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$125.65 |
| Max. Negotiated Rate |
$257.00 |
| Rate for Payer: Aetna American Axle |
$185.61
|
| Rate for Payer: Aetna Commercial |
$242.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$185.61
|
| Rate for Payer: Cash Price |
$228.45
|
| Rate for Payer: Cofinity Commercial |
$199.89
|
| Rate for Payer: Cofinity Commercial |
$245.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$228.45
|
| Rate for Payer: Healthscope Commercial |
$257.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$199.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$214.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$242.73
|
| Rate for Payer: PHP Commercial |
$242.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$199.89
|
| Rate for Payer: Priority Health SBD |
$179.90
|
| Rate for Payer: UMR Bronson Commercial |
$125.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$214.17
|
|
|
FOLIC ACID-VIT B6-VIT B12 2.5 MG-25 MG-2 MG TABLET
|
Facility
|
IP
|
$424.94
|
|
|
Service Code
|
NDC 5199138490
|
| Hospital Charge Code |
38624
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$186.97 |
| Max. Negotiated Rate |
$382.45 |
| Rate for Payer: Aetna American Axle |
$276.21
|
| Rate for Payer: Aetna Commercial |
$361.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$276.21
|
| Rate for Payer: Cash Price |
$339.95
|
| Rate for Payer: Cofinity Commercial |
$297.46
|
| Rate for Payer: Cofinity Commercial |
$365.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$339.95
|
| Rate for Payer: Healthscope Commercial |
$382.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$297.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$318.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$361.20
|
| Rate for Payer: PHP Commercial |
$361.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$297.46
|
| Rate for Payer: Priority Health SBD |
$267.71
|
| Rate for Payer: UMR Bronson Commercial |
$186.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$318.70
|
|
|
FOMEPIZOLE 1 GRAM/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$1,624.90
|
|
|
Service Code
|
HCPCS J1451
|
| Hospital Charge Code |
22185
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$714.96 |
| Max. Negotiated Rate |
$1,462.41 |
| Rate for Payer: Aetna American Axle |
$1,056.18
|
| Rate for Payer: Aetna American Axle |
$1,089.76
|
| Rate for Payer: Aetna American Axle |
$1,907.30
|
| Rate for Payer: Aetna Commercial |
$2,494.16
|
| Rate for Payer: Aetna Commercial |
$1,425.07
|
| Rate for Payer: Aetna Commercial |
$1,381.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,907.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,056.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,089.76
|
| Rate for Payer: Cash Price |
$1,299.92
|
| Rate for Payer: Cash Price |
$2,347.45
|
| Rate for Payer: Cash Price |
$1,341.24
|
| Rate for Payer: Cofinity Commercial |
$1,173.58
|
| Rate for Payer: Cofinity Commercial |
$1,137.43
|
| Rate for Payer: Cofinity Commercial |
$1,397.41
|
| Rate for Payer: Cofinity Commercial |
$1,441.83
|
| Rate for Payer: Cofinity Commercial |
$2,523.51
|
| Rate for Payer: Cofinity Commercial |
$2,054.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,299.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,341.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,347.45
|
| Rate for Payer: Healthscope Commercial |
$2,640.88
|
| Rate for Payer: Healthscope Commercial |
$1,462.41
|
| Rate for Payer: Healthscope Commercial |
$1,508.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,173.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,054.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,137.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,200.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,218.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,257.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,425.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,381.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,494.16
|
| Rate for Payer: PHP Commercial |
$1,381.16
|
| Rate for Payer: PHP Commercial |
$1,425.07
|
| Rate for Payer: PHP Commercial |
$2,494.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,054.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,137.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,173.58
|
| Rate for Payer: Priority Health SBD |
$1,848.62
|
| Rate for Payer: Priority Health SBD |
$1,056.23
|
| Rate for Payer: Priority Health SBD |
$1,023.69
|
| Rate for Payer: UMR Bronson Commercial |
$714.96
|
| Rate for Payer: UMR Bronson Commercial |
$737.68
|
| Rate for Payer: UMR Bronson Commercial |
$1,291.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,257.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,218.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,200.73
|
|
|
FONDAPARINUX 10 MG/0.8 ML SUBCUTANEOUS SOLUTION SYRINGE
|
Facility
|
IP
|
$132.53
|
|
|
Service Code
|
HCPCS J1652
|
| Hospital Charge Code |
115590
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$58.31 |
| Max. Negotiated Rate |
$119.28 |
| Rate for Payer: Aetna American Axle |
$86.14
|
| Rate for Payer: Aetna American Axle |
$28.25
|
| Rate for Payer: Aetna Commercial |
$112.65
|
| Rate for Payer: Aetna Commercial |
$36.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$86.14
|
| Rate for Payer: Cash Price |
$106.02
|
| Rate for Payer: Cash Price |
$34.77
|
| Rate for Payer: Cofinity Commercial |
$37.38
|
| Rate for Payer: Cofinity Commercial |
$113.98
|
| Rate for Payer: Cofinity Commercial |
$92.77
|
| Rate for Payer: Cofinity Commercial |
$30.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$106.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.77
|
| Rate for Payer: Healthscope Commercial |
$39.11
|
| Rate for Payer: Healthscope Commercial |
$119.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$92.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$30.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$99.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$112.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$36.94
|
| Rate for Payer: PHP Commercial |
$36.94
|
| Rate for Payer: PHP Commercial |
$112.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$92.77
|
| Rate for Payer: Priority Health SBD |
$27.38
|
| Rate for Payer: Priority Health SBD |
$83.49
|
| Rate for Payer: UMR Bronson Commercial |
$58.31
|
| Rate for Payer: UMR Bronson Commercial |
$19.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$99.40
|
|
|
FONDAPARINUX 2.5 MG/0.5 ML SUBCUTANEOUS SOLUTION SYRINGE
|
Facility
|
IP
|
$27.18
|
|
|
Service Code
|
HCPCS J1652
|
| Hospital Charge Code |
32215
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$11.96 |
| Max. Negotiated Rate |
$24.46 |
| Rate for Payer: Aetna American Axle |
$17.67
|
| Rate for Payer: Aetna American Axle |
$26.96
|
| Rate for Payer: Aetna Commercial |
$35.25
|
| Rate for Payer: Aetna Commercial |
$23.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.67
|
| Rate for Payer: Cash Price |
$21.74
|
| Rate for Payer: Cash Price |
$33.18
|
| Rate for Payer: Cofinity Commercial |
$23.37
|
| Rate for Payer: Cofinity Commercial |
$19.03
|
| Rate for Payer: Cofinity Commercial |
$35.66
|
| Rate for Payer: Cofinity Commercial |
$29.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.18
|
| Rate for Payer: Healthscope Commercial |
$24.46
|
| Rate for Payer: Healthscope Commercial |
$37.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$29.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$19.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$35.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$23.10
|
| Rate for Payer: PHP Commercial |
$23.10
|
| Rate for Payer: PHP Commercial |
$35.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.03
|
| Rate for Payer: Priority Health SBD |
$26.13
|
| Rate for Payer: Priority Health SBD |
$17.12
|
| Rate for Payer: UMR Bronson Commercial |
$11.96
|
| Rate for Payer: UMR Bronson Commercial |
$18.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.10
|
|
|
FONDAPARINUX 5 MG/0.4 ML SUBCUTANEOUS SOLUTION SYRINGE
|
Facility
|
IP
|
$132.53
|
|
|
Service Code
|
HCPCS J1652
|
| Hospital Charge Code |
115589
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$58.31 |
| Max. Negotiated Rate |
$119.28 |
| Rate for Payer: Aetna American Axle |
$86.14
|
| Rate for Payer: Aetna Commercial |
$112.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$86.14
|
| Rate for Payer: Cash Price |
$106.02
|
| Rate for Payer: Cofinity Commercial |
$113.98
|
| Rate for Payer: Cofinity Commercial |
$92.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$106.02
|
| Rate for Payer: Healthscope Commercial |
$119.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$92.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$99.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$112.65
|
| Rate for Payer: PHP Commercial |
$112.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$92.77
|
| Rate for Payer: Priority Health SBD |
$83.49
|
| Rate for Payer: UMR Bronson Commercial |
$58.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$99.40
|
|
|
FONDAPARINUX 7.5 MG/0.6 ML SUBCUTANEOUS SOLUTION SYRINGE
|
Facility
|
IP
|
$419.12
|
|
|
Service Code
|
HCPCS J1652
|
| Hospital Charge Code |
39803
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$184.41 |
| Max. Negotiated Rate |
$377.21 |
| Rate for Payer: Aetna American Axle |
$272.43
|
| Rate for Payer: Aetna American Axle |
$86.14
|
| Rate for Payer: Aetna Commercial |
$112.65
|
| Rate for Payer: Aetna Commercial |
$356.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$86.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$272.43
|
| Rate for Payer: Cash Price |
$335.30
|
| Rate for Payer: Cash Price |
$106.02
|
| Rate for Payer: Cofinity Commercial |
$113.98
|
| Rate for Payer: Cofinity Commercial |
$360.44
|
| Rate for Payer: Cofinity Commercial |
$293.38
|
| Rate for Payer: Cofinity Commercial |
$92.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$106.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$335.30
|
| Rate for Payer: Healthscope Commercial |
$377.21
|
| Rate for Payer: Healthscope Commercial |
$119.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$92.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$293.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$314.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$99.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$112.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$356.25
|
| Rate for Payer: PHP Commercial |
$112.65
|
| Rate for Payer: PHP Commercial |
$356.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$92.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$293.38
|
| Rate for Payer: Priority Health SBD |
$83.49
|
| Rate for Payer: Priority Health SBD |
$264.05
|
| Rate for Payer: UMR Bronson Commercial |
$58.31
|
| Rate for Payer: UMR Bronson Commercial |
$184.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$99.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$314.34
|
|
|
FOOT PROCEDURES WITH CC
|
Facility
|
IP
|
$36,404.38
|
|
|
Service Code
|
MS-DRG 504
|
| Min. Negotiated Rate |
$13,130.38 |
| Max. Negotiated Rate |
$36,404.38 |
| Rate for Payer: Aetna Medicare |
$14,374.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17,276.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17,276.81
|
| Rate for Payer: BCBS MAPPO |
$13,821.45
|
| Rate for Payer: BCBS Trust/PPO |
$36,404.38
|
| Rate for Payer: BCN Medicare Advantage |
$13,821.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13,821.45
|
| Rate for Payer: Mclaren Medicare |
$13,821.45
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$14,512.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15,894.67
|
| Rate for Payer: PACE Medicare |
$13,130.38
|
| Rate for Payer: PACE SWMI |
$13,821.45
|
| Rate for Payer: PHP Medicare Advantage |
$13,821.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$24,783.75
|
| Rate for Payer: Priority Health Medicare |
$13,821.45
|
| Rate for Payer: Priority Health Narrow Network |
$19,827.00
|
| Rate for Payer: Railroad Medicare Medicare |
$13,821.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26,345.18
|
| Rate for Payer: UHC Core |
$21,602.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$13,821.45
|
| Rate for Payer: UHC Exchange |
$17,174.28
|
| Rate for Payer: UHC Medicare Advantage |
$14,236.09
|
| Rate for Payer: VA VA |
$13,821.45
|
|
|
FOOT PROCEDURES WITH MCC
|
Facility
|
IP
|
$40,909.70
|
|
|
Service Code
|
MS-DRG 503
|
| Min. Negotiated Rate |
$20,120.21 |
| Max. Negotiated Rate |
$40,909.70 |
| Rate for Payer: Aetna Medicare |
$22,026.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26,473.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26,473.96
|
| Rate for Payer: BCBS MAPPO |
$21,179.17
|
| Rate for Payer: BCBS Trust/PPO |
$38,261.42
|
| Rate for Payer: BCN Medicare Advantage |
$21,179.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21,179.17
|
| Rate for Payer: Mclaren Medicare |
$21,179.17
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$22,238.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24,356.05
|
| Rate for Payer: PACE Medicare |
$20,120.21
|
| Rate for Payer: PACE SWMI |
$21,179.17
|
| Rate for Payer: PHP Medicare Advantage |
$21,179.17
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$38,485.05
|
| Rate for Payer: Priority Health Medicare |
$21,179.17
|
| Rate for Payer: Priority Health Narrow Network |
$30,788.04
|
| Rate for Payer: Railroad Medicare Medicare |
$21,179.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40,909.70
|
| Rate for Payer: UHC Core |
$33,545.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$21,179.17
|
| Rate for Payer: UHC Exchange |
$26,668.81
|
| Rate for Payer: UHC Medicare Advantage |
$21,814.55
|
| Rate for Payer: VA VA |
$21,179.17
|
|
|
FOOT PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$27,561.49
|
|
|
Service Code
|
MS-DRG 505
|
| Min. Negotiated Rate |
$12,973.70 |
| Max. Negotiated Rate |
$27,561.49 |
| Rate for Payer: Aetna Medicare |
$14,202.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17,070.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17,070.66
|
| Rate for Payer: BCBS MAPPO |
$13,656.53
|
| Rate for Payer: BCBS Trust/PPO |
$27,561.49
|
| Rate for Payer: BCN Medicare Advantage |
$13,656.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13,656.53
|
| Rate for Payer: Mclaren Medicare |
$13,656.53
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$14,339.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15,705.01
|
| Rate for Payer: PACE Medicare |
$12,973.70
|
| Rate for Payer: PACE SWMI |
$13,656.53
|
| Rate for Payer: PHP Medicare Advantage |
$13,656.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$24,476.66
|
| Rate for Payer: Priority Health Medicare |
$13,656.53
|
| Rate for Payer: Priority Health Narrow Network |
$19,581.33
|
| Rate for Payer: Railroad Medicare Medicare |
$13,656.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26,018.75
|
| Rate for Payer: UHC Core |
$21,334.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$13,656.53
|
| Rate for Payer: UHC Exchange |
$16,961.48
|
| Rate for Payer: UHC Medicare Advantage |
$14,066.23
|
| Rate for Payer: VA VA |
$13,656.53
|
|
|
FOREHEAD FLAP WITH PRESERVATION OF VASCULAR PEDICLE (EG, AXIAL PATTERN FLAP, PARAMEDIAN FOREHEAD FLAP)
|
Facility
|
OP
|
$10,039.01
|
|
|
Service Code
|
CPT 15731
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$979.71 |
| Max. Negotiated Rate |
$10,039.01 |
| Rate for Payer: Aetna Medicare |
$3,316.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,986.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,986.20
|
| Rate for Payer: BCBS Complete |
$1,831.74
|
| Rate for Payer: BCBS MAPPO |
$3,188.96
|
| Rate for Payer: BCBS Trust/PPO |
$2,344.98
|
| Rate for Payer: BCN Medicare Advantage |
$3,188.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,188.96
|
| Rate for Payer: Mclaren Medicaid |
$1,744.36
|
| Rate for Payer: Mclaren Medicare |
$3,188.96
|
| Rate for Payer: Meridian Medicaid |
$1,831.74
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,348.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,667.30
|
| Rate for Payer: PACE Medicare |
$3,029.51
|
| Rate for Payer: PACE SWMI |
$3,188.96
|
| Rate for Payer: PHP Medicare Advantage |
$3,188.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,744.36
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10,039.01
|
| Rate for Payer: Priority Health Medicare |
$3,188.96
|
| Rate for Payer: Priority Health Narrow Network |
$8,031.21
|
| Rate for Payer: Railroad Medicare Medicare |
$3,188.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,077.68
|
| Rate for Payer: UHC Core |
$5,042.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,188.96
|
| Rate for Payer: UHC Exchange |
$979.71
|
| Rate for Payer: UHC Medicare Advantage |
$3,284.63
|
| Rate for Payer: VA VA |
$3,188.96
|
|
|
FORESKIN MANIPULATION INCLUDING LYSIS OF PREPUTIAL ADHESIONS AND STRETCHING
|
Facility
|
OP
|
$700.00
|
|
|
Service Code
|
CPT 54450
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$55.34 |
| Max. Negotiated Rate |
$700.00 |
| Rate for Payer: Aetna Medicare |
$228.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$274.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$274.60
|
| Rate for Payer: BCBS Complete |
$126.18
|
| Rate for Payer: BCBS MAPPO |
$219.68
|
| Rate for Payer: BCBS Trust/PPO |
$173.36
|
| Rate for Payer: BCN Medicare Advantage |
$219.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$219.68
|
| Rate for Payer: Mclaren Medicaid |
$120.16
|
| Rate for Payer: Mclaren Medicare |
$219.68
|
| Rate for Payer: Meridian Medicaid |
$126.18
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$230.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$252.63
|
| Rate for Payer: PACE Medicare |
$208.70
|
| Rate for Payer: PACE SWMI |
$219.68
|
| Rate for Payer: PHP Medicare Advantage |
$219.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$120.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$691.57
|
| Rate for Payer: Priority Health Medicare |
$219.68
|
| Rate for Payer: Priority Health Narrow Network |
$553.26
|
| Rate for Payer: Railroad Medicare Medicare |
$219.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$60.87
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$219.68
|
| Rate for Payer: UHC Exchange |
$55.34
|
| Rate for Payer: UHC Medicare Advantage |
$226.27
|
| Rate for Payer: VA VA |
$219.68
|
|
|
FORMATION OF DIRECT OR TUBED PEDICLE, WITH OR WITHOUT TRANSFER; EYELIDS, NOSE, EARS, LIPS, OR INTRAORAL
|
Facility
|
OP
|
$5,102.91
|
|
|
Service Code
|
CPT 15576
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$635.89 |
| Max. Negotiated Rate |
$5,102.91 |
| Rate for Payer: Aetna Medicare |
$1,685.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,026.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,026.22
|
| Rate for Payer: BCBS Complete |
$931.09
|
| Rate for Payer: BCBS MAPPO |
$1,620.98
|
| Rate for Payer: BCBS Trust/PPO |
$1,744.94
|
| Rate for Payer: BCN Medicare Advantage |
$1,620.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,620.98
|
| Rate for Payer: Mclaren Medicaid |
$886.68
|
| Rate for Payer: Mclaren Medicare |
$1,620.98
|
| Rate for Payer: Meridian Medicaid |
$931.09
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,702.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,864.13
|
| Rate for Payer: PACE Medicare |
$1,539.93
|
| Rate for Payer: PACE SWMI |
$1,620.98
|
| Rate for Payer: PHP Medicare Advantage |
$1,620.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$886.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,102.91
|
| Rate for Payer: Priority Health Medicare |
$1,620.98
|
| Rate for Payer: Priority Health Narrow Network |
$4,082.33
|
| Rate for Payer: Railroad Medicare Medicare |
$1,620.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$699.48
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,620.98
|
| Rate for Payer: UHC Exchange |
$635.89
|
| Rate for Payer: UHC Medicare Advantage |
$1,669.61
|
| Rate for Payer: VA VA |
$1,620.98
|
|
|
FORMATION OF DIRECT OR TUBED PEDICLE, WITH OR WITHOUT TRANSFER; FOREHEAD, CHEEKS, CHIN, MOUTH, NECK, AXILLAE, GENITALIA, HANDS OR FEET
|
Facility
|
OP
|
$5,102.91
|
|
|
Service Code
|
CPT 15574
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$727.90 |
| Max. Negotiated Rate |
$5,102.91 |
| Rate for Payer: Aetna Medicare |
$1,685.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,026.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,026.22
|
| Rate for Payer: BCBS Complete |
$931.09
|
| Rate for Payer: BCBS MAPPO |
$1,620.98
|
| Rate for Payer: BCBS Trust/PPO |
$1,744.94
|
| Rate for Payer: BCN Medicare Advantage |
$1,620.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,620.98
|
| Rate for Payer: Mclaren Medicaid |
$886.68
|
| Rate for Payer: Mclaren Medicare |
$1,620.98
|
| Rate for Payer: Meridian Medicaid |
$931.09
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,702.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,864.13
|
| Rate for Payer: PACE Medicare |
$1,539.93
|
| Rate for Payer: PACE SWMI |
$1,620.98
|
| Rate for Payer: PHP Medicare Advantage |
$1,620.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$886.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,102.91
|
| Rate for Payer: Priority Health Medicare |
$1,620.98
|
| Rate for Payer: Priority Health Narrow Network |
$4,082.33
|
| Rate for Payer: Railroad Medicare Medicare |
$1,620.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$800.69
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,620.98
|
| Rate for Payer: UHC Exchange |
$727.90
|
| Rate for Payer: UHC Medicare Advantage |
$1,669.61
|
| Rate for Payer: VA VA |
$1,620.98
|
|
|
FORMOTEROL FUMARATE 20 MCG/2 ML SOLUTION FOR NEBULIZATION
|
Facility
|
IP
|
$16.17
|
|
|
Service Code
|
HCPCS J7606
|
| Hospital Charge Code |
88225
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$7.11 |
| Max. Negotiated Rate |
$14.55 |
| Rate for Payer: Aetna American Axle |
$10.51
|
| Rate for Payer: Aetna American Axle |
$17.88
|
| Rate for Payer: Aetna Commercial |
$23.38
|
| Rate for Payer: Aetna Commercial |
$13.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.88
|
| Rate for Payer: Cash Price |
$22.01
|
| Rate for Payer: Cash Price |
$12.94
|
| Rate for Payer: Cofinity Commercial |
$11.32
|
| Rate for Payer: Cofinity Commercial |
$23.66
|
| Rate for Payer: Cofinity Commercial |
$19.26
|
| Rate for Payer: Cofinity Commercial |
$13.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.01
|
| Rate for Payer: Healthscope Commercial |
$14.55
|
| Rate for Payer: Healthscope Commercial |
$24.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$19.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$13.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$23.38
|
| Rate for Payer: PHP Commercial |
$23.38
|
| Rate for Payer: PHP Commercial |
$13.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.26
|
| Rate for Payer: Priority Health SBD |
$10.19
|
| Rate for Payer: Priority Health SBD |
$17.33
|
| Rate for Payer: UMR Bronson Commercial |
$7.11
|
| Rate for Payer: UMR Bronson Commercial |
$12.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.63
|
|
